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Introduction

International Journal of Psychoanalysis. 2007; 88:1-16

The seeds of creativity have the potential to germinate and flourish within the rich, ambiguous and unsettling tapestry of the core dialectical tensions related to the central organizing dialectic, life and death, generated in the patient–analyst relating. The author introduces the concept of the ‘dialectical edge’ and describes it as the pivotal point in the dialectical struggle within these core dialectical dilemmas. This is a fluid, emotionally evocative threshold, where there is maximum potential for change, as well as for homeostatic stagnation. Drawing on Winnicott, the author illustrates how the presence of an edge within these dialectical dilemmas has the potential to open up into a creative, reflective space. He suggests that this, however, will depend on the therapist’s capacity to contain/hold at this edge the arousing and intense affects—such as anxiety, dread, excitement and passion—that are inevitably generated at these pivotal relational moments. This will determine whether the patient will move forwards into the light of a creative, reflective, dialectical space, or backwards into collapsed, non-reflective darkness, where fluid oscillation is transformed into rigid ossification. The author uses a clinical example to illustrate these dialectical phenomena, with a special focus on two clinically relevant dialectics, i.e. ‘ritual versus spontaneity’ and ‘closeness versus separateness’.

It was a hot, dry Sydney December summer. A raging fire erupted in the forest close to my home, fuelled by the combination of heat, wind and flammable oils from the eucalyptus trees. As I stood on my deck, observing the bellowing flames, I became aware of deeply confusing, contradictory, unlanguaged feelings welling up inside me. I experienced a sense of devastation and despair at the loss of vegetation and animal life, yet, at the same time, I had an excited sense at the possibility for rejuvenation and change, appreciating the revitalising effect that fires can have on the Australian bush.

When I visited the site weeks later, rather than finding a forest graveyard, I was greeted by young banksia seedlings standing triumphantly in the rich, blackened soil. Their seeds had been freed from their ridged encasement by the heat of the flames. I became aware of the highly evocative and fluid ‘edge’ that had arisen within the inherent dialectical struggles of life and death, light and dark, growth and stagnation. I was struck by the fragility of the Australian ecosystem and its dependence on the delicate balance that exists within the forces of this life–death dialectic. There is a particular point/edge where too much fire could destroy the fauna, yet too little heat and combustion would be unable to facilitate the liberation and germination of the vital seeds. It is the understanding of this edge that I would like to deepen by transferring our understanding of these dialectical processes in nature (and their potential for change) to our clinical work.

Many of our patients have developed rigid ‘Banksia-type’ casings, in an attempt to protect themselves from experiencing deeply felt emotional pain and anxiety. I would like to propose that, if we are to help them, we need to develop a deep understanding of their particular dialectical dysfunction. The next challenge is not only to be able to identify the crucial edge within this particular dialectic, but to be able to be there with the patient, in an emotionally present manner.

I attempt to illustrate later that, if we can enter the patient’s delicate emotional ‘ecosystem’ in what I have termed a ‘dialectically attuned’ manner, we may be able to facilitate the opening up of a creative reflective space, in which positive transformation can occur.

I found Ogden’s definition of a dialectic very helpful while grappling to understand the very complex, and apparently paradoxical, relationship that life and death (and indeed all dialectical elements) have with one another:

A dialectic is a process in which each of the two opposing concepts creates, informs, preserves and negates

one another, each stands in a dynamic ever changing relationship with the other. The dialectical process

moves toward integration, but integration is never complete. Each integration creates a new dialectical

opposition and a new dynamic tension. (1992a, p. 208)

Life and death, and their related dialectics, could hardly appear more opposite, yet are defined by one another. They are so close, sharing opposite sides of the same coin, yet never fully integrate.

The life–death and other dialectical entities have been prime movers and pivotal architects in the development and understanding of many of our psychoanalytic concepts. In Beyond the pleasure principle, Freud (1920) evoked the notion of the life–death instinct in order to give explanatory power to the notion of repetition compulsion and resistance. Melanie Klein’s (1957) understanding of the life–death instinct formed the basis of her thinking around aggression, the dynamics of splitting projection and projective identification, as well as her concepts of the paranoid–schizoid and depressive position.

Bion’s (1962) major dialectical contribution was demonstrated in his understanding of the container–contained dialectic. I discuss later how vital adequate containment is in the development of a creative dialectical space. Hoffman, a more contemporary psychoanalyst, drawing on his theory of ‘dialectical-constructivism’, describes how he sees the dialectic of life–death existing as a core organizing principle: ‘What emerges as a kind of psychobiological bedrock, is the immutable, trans-cultural, trans-historical truth that human beings create their sense of meaning in the teeth of the constant threat of non-being and meaninglessness’ (1998, p. 16).2 Of all the analytic thinkers, it could be argued that Winnicott had the most profound and intuitive understanding of dialectic phenomena, even though he may not have explicitly used this language (Ogden, 1992b). Winnicott anticipated the understanding of dialectical-constructivism 30 years earlier, and conceptualized a mental space/situation, i.e. a potential space in which creative transformational thought could come alive (Winnicott, 1971a). He created a theory of mind that could account, theoretically and experientially, for how we are able to cope productively with the realities of loss, separation and death (1953).

Ogden noted that, for his understanding of transitional phenomena and their potential for creativity, Winnicott drew on a multitude of dialectical phenomena, such as ‘me–not me’, ‘subject–object’, ‘illusion–reality’ and ‘internal–external’ (Ogden, 1992b).

The dialectical edge within the space

Although Winnicott made no direct reference to the idea of a dialectical edge in his work, I hope to be able to demonstrate that this notion was nevertheless reflected in his clinical understanding of, and writing on, potential space. I attempt to explore Winnicott’s ‘insulated’ language (Ogden,1992a p. 206) to see if I can produce convincing evidence for the notion of the dialectical edge in his work on transitional phenomena.

Winnicott describes potential space in the following way: ‘For creative playing and cultural experience, the position is the potential space ... that exists (but cannot exist) between baby and object (mother or part mother)’ (1971a, p. 107).

When Winnicott talks of the ‘potential space’, I believe that he is referring to the ‘inherent’ capacity that the space lying between two dialectical entities has, to be able to manifest as a creative reflective space, under the appropriate environmental (ecosystemic) conditions. When Winnicott refers to ‘the position of potential space’, he goes on to say, ‘I refer to the hypothetical area that exists ... between the baby and object ... during the phase of repudiation of the object as not-me, that is at the end of being merged in with the object’ (1971a, p. 107, my italics). Winnicott then goes on to describe the transition that occurs at the end ‘from a state of being merged in with the mother ... the baby is at a stage of separating the mother from the self’ (p. 107). This ‘end’ of merger that Winnicott describes is also the beginning of separation. In this sense, this ‘end’ could well be termed ‘edge’—the edge within the merger–separation dialectic.

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2If we allow our minds to associate from life–death to other dialectics, we might begin to notice how they are all interconnected—how the dialectic of life and death is able to ‘spawn’ other related dialectics, notably ‘meaning and mortality’, ‘attachment and separation’, ‘order and change’, ‘ritual and spontaneity’. These dyadic ‘couples’ link up with other related ‘couples’ to form an interconnecting dyadic community, or ‘dialectical matrix’, where the dialectic of life–death is at its epicentre. I will later elaborate more fully how this multitude of incomplete gestalts provides the necessary tension, frustration, not knowing and absence that is vital for the generation of creative symbolic thought.

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There is another brief description in Winnicott’s writing that I believe gives further credence to my idea of a position within a dialectical space that we can call the ‘dialectical edge’. He notes that

It may perhaps be seen ... how important it can be for the analyst to recognise the

existence of this place [potential space], the only place where play can start, a

place at the continuity— contiguity moment where transitional phenomena originate. (1971b, p. 103)

Winnicott links continuity, defined as ‘a state of being continues’, with contiguity, defined as ‘contact’, ‘adjoining’, ‘proximity of ideas’ (Concise Oxford dictionary, 2004). I believe that Winnicott is describing what we could term a dialectical edge, a ‘contact point’ where at any given moment two dialectical entities connect, i.e. we have a ‘proximity of ideas’. Winnicott appears to be aware of how crucial this end/edge is in our clinical work, alerting us to our potential to harm patients at this critical point. He notes that

This is the same danger area that is arrived at sooner or later, in all psychiatric treatments ... with

the therapist’s readiness to let go ... any move from the therapist away from a state of being merged

in with the patient is under dire suspicion, so that disaster threatens. (1971a, p. 107, my italics)

It is this ‘danger area’, this ‘end’, this ‘moment’ that corresponds to what I call the ‘dialectical edge’. It is at this edge that the dialectics of life–death and related dialectics—me vs. not me, closeness vs. separation, and change vs. homeostasis, etc.—enact their inevitable dialectical dance.

I hope to show in my clinical example below how this ‘danger area’ in the analytic relationship can be rendered safer by the analyst’s holding and containment, facilitating the development of a creative analytic space where risks can be taken, allowing positive transformation to occur.

We are as humans ‘edgy’ by nature. Like Vasco da Gamas of old, we are drawn by a magnetic curiosity to the edge, to know, understand and discover the limits of our beings and, indeed, our universe. Research has demonstrated that our epistomophilic drive and curiosity appears to be present from birth. An infant, if given the choice, would choose something novel over food (Stern, 1985). As much as we are driven and compelled evolutionarily to seek change and diversity, we are equally driven and compelled to seek stability and homeostasis. In this sense, we are both epistomophilic and epistimophobic. When patients (as we see later in my clinical example) initially present to us, they are, we might say, in a state of dialectical ambiguity, upheaval and despair. While they seek knowledge, change and newness, they also seek sameness; while they seek closeness and union, they seek separateness. These dialectical derivatives of the life–death dilemma are, as I hope to illustrate, a source of pain and despair, as well as hope and creativity. It is my suggestion that each of these dialectics that form part of the dialectical matrix described earlier have an inherent edge, and each edge has the potential to open up into a creative space. I want to illustrate how vital this edge is, particularly within our psychoanalytic context. It is important, I believe, to identify this place so that we can make maximum use of its generative potential and minimize the potential for harm.3 Before we can do this, however, I would like to expand further on what it is that enables a dialectical edge to be transformed into a creative play, reflective and symbolic space. In order to understand this, we need to appreciate how vital and potentially transformational the tensions are that arise in the dialectical relationship between irresolvable tension and holding/containment.

Irresolvable tension

Gregory Bateson recognized that human systems are information dependent and need an ongoing source of new information in order to survive. He proposed that ‘information is a difference’ (1980, p. 104). I would like to suggest that the ‘difference-information that arises out of dialectical dilemmas is particularly rich, disturbing and unsettling, and by nature can never achieve closure. Whenever a gestalt is incomplete, it leaves us in a state of tension, anticipation, frustration and anxiety’ (Perls, 1973). While there is no closure, we have irresolvable tension that guarantees the flow of information.

The potential for an incomplete gestalt to act as a rich recourse for our creative thoughts is well known to many psychoanalytic thinkers. When discussing the nature of the transitional phenomena, Winnicott states, ‘The searching can come only from desultory formless functioning ... . It is only here, in this unintegrated state ... which that which we can describe as creative can appear’ (1971a, p. 64).

Edna O’Shaughnessy notes,

The absent object is a spur to the development of thought. You can be asked to think of

something that is absent—a painting—but you can’t be asked to think of a painting you are already looking at.

Perception shuts out thought. (1964, p. 34)

Bion (1962) echoes this, emphasising that tolerance of frustration is essential for thought development; the absent object/breast giving the child his/her first opportunity to know reality through thought.

Holding and containment

Winnicott and Bion have, at the core of their theory of mind, the notion of the incomplete gestalt, and they understand well how the anxiety and frustration arising out of this state provides the ‘fuel’ for our reflective and symbolic capacity. They also recognise, however, that overwhelming tensions untempered by ‘holding’ for Winnicott (1960) and ‘containment’ for Bion (1962) can lead to ‘a failure to play’ (Winnicott, 1971a) and ‘nameless dread’ (Bion, 1962).

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3While writing up my clinical illustration, it became clearer to me why my patient Jim was so passionate about sky diving. It occurred to me that this ‘edgy’, high-risk, high-gain situation allowed him to experience the freedom of free fall, in the context of a firm holding. In extreme sports, detailed attention is paid to ensuring the safety of the holding gear. This allows the participants to experience a ‘close to the edge’, life–death experience in a safe and lively space. I am suggesting that, in our work, a secure holding at the edge within vital relational dialectics will potentially open up a potent creative transformational space.

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Winnicott notes that ‘Playing is essentially satisfying. This is true even when it leads to a high degree of anxiety. There is a degree of anxiety, however, that is unbearable and destroys play’ (1971a, p. 52).

Winnicott and Bion might have said that there is no such thing as symbolic function—there is only symbolic function plus holding (Winnicott, 1960) and containment (Bion, 1962).

This capacity for holding and containment is often poorly represented as an internal function in deeply troubled patients (such as Jim, described below). In these situations, we, as analysts, need to be able to provide this third function, which is vital for the development and maintenance of a dialectical space and, therefore, for symbolic function and creative thought (Ogden, 1992a)

In dialectical terms, the reflective third is represented by what might be termed a ‘dialectically attuned therapist’ (originally mother). The dialectically attuned therapist functions by mentally/emotionally processing the information that is continually being generated by the colliding differences activated by opposing, yet interdependent dialectical elements. The dialectically attuned therapist regulates the oscillation according to the system’s demands, by attending to each dynamic figure- ground oscillation in relation to each unique moment in its relational configuration. When there is a breakdown or absence of a dialectically aware ‘third’, fluid dialectical oscillation is lost. It is under these conditions that there is then a risk, as illustrated below, of dialectical ossification and what I have termed dialectical atelectasis.

Clinical illustration

I would now like to attempt to demonstrate the clinical importance of being able to identify the particular troubling dialectics and the vital edges within them. Having done this, I would like to illustrate how vital our role is in determining the outcome of the relational drama that is enacted at the edge. The particular dialectical entities that were relevant in this situation were closeness vs. separateness and ritual vs. spontaneity.

My patient Jim lives alone and is an environmental scientist in his late thirties. He is tall and rather unco-ordinated, and almost always wears khaki ‘bush’ clothes that hang untidily on him. His fine, sensitive features are all but covered by a thick black beard.

He conveyed the following picture of his emotional life during our initial interviews. He told me that he sought out an analysis with me because he felt that he was ‘living in a vacuum’, that his life had little meaning or joy, and that he lacked inspiration and drive. He acknowledged that he struggled to maintain ongoing intimate relationships and was tired of living alone. He described how there were two main ways in which he could find some relief from his pain and loneliness. The one involved immersing himself in his research and work as a marine biologist. He stated that it gave him a certain amount of pleasure and relief when he was able to discover new shells and marine animals while exploring the rock pools in the marine reserve near his home. The other activity had to do with his longstanding weekend activity of sky diving: ‘People can’t believe that a geek like me would have the courage to jump out of planes. I love that free-fall feeling, a mixture of fear and excitement’. He admitted that he was painfully lonely and would enjoy these activities more if he had company. He was, however, fearful of this prospect, reporting being ‘burned’ too many times in past relationships.

Jim told me that he had suffered a great deal as a child. His father left when he was only 2 and his mother had many partners. He reported that ‘between partners she was all over me but when she found a man she dropped me like a hot cake ... I was an only child and always longed for a brother or sister ... I tended to cling to one friend at a time but these relationships were always interrupted by our frequent moves ... I’m sure all this has screwed up my ability to relate properly’.

During the assessment, Jim made little eye contact and seemed relieved at the opportunity to lie on the couch. His agony and discomfort in discussing emotionally laden issues was palpable. He would almost instinctively and automatically withdraw and avoid emotional tensions, at times curling up almost in a foetal position. He spoke in guarded, flat, low tones and had difficulty in being able to free associate. His thinking and responses were often rather concrete and lacked imagination and elaboration. In Winnicott’s terms, one might say that Jim had lost his capacity for ‘creative play’. For Winnicott, the opposite of creativity is compliance: ‘Compliance carries with it a sense of futility for the individual and is associated with the idea that nothing matters and that life is not worth living’ (1971a, p. 65).

I felt that the idea of a compliant individual who conformed and adapted was a useful description, but did not seem to fit Jim’s mental state. He was not overly compliant; if anything, he was a bit eccentric and socially unaware. I was much more struck by the persistence of the ‘paralysing fog’ that seemed to occupy the mental emotional space between us, depriving it of its vital and creative potential.

While grappling to maintain a creative, reflective space with Jim, I developed associations that helped to convey a more fitting state of mind in Jim than ‘compliant’.

I recalled my painful and distressing days when I worked in a crowded African hospital on the outskirts of Johannesburg. One of the most frequent and dramatic emergencies that we had to deal with was the condition known as Atelectasis, i.e. collapse of the lung, most commonly caused by stab wounds. In these situations, it was critical to get the lungs inflated as soon as possible to try to open up a space to allow oxygen to flow. If this was not done, the decrease in oxygen, build-up of carbon dioxide, stasis and lack of fluid flow would create a nidus for bacterial infection. The alveoli are to the matrix of the lungs as dialectical dyads are to the dialectical matrix. Balanced gaseous flow and exchange corresponds to balanced dialectical oscillation and reflection. As with the atelectic lungs, the vital potential space between Jim and I was often in, or near, a state of collapse.

Jim’s traumatic experience of closeness and separateness in his relationship to significant others in his early development led to the development of specific relationship templates, which Bowlby (1973) has termed ‘internal working models’. I prefer to talk of these relationship schemas as ‘internal belief systems’ or, better still, ‘experiential believing systems’—‘believing’ because they are felt to be true and ‘experiential’ because they are experienced in the here and now. These encoded traumas lie in waiting just below the surface, ready to be activated by interpersonal signals that are filtered by the highly subjective lenses of an individual’s believing systems.4

Jim’s believing system, which arose out of his formative experience with significant others, gave rise to the characteristic ‘trio’ of anxieties/phobias relating to merger and abandonment, i.e. to hurt, be hurt, and the loss of self (Israelstam, 1989a, 1989b). Through the understanding of Jim’s transference responses, a picture of his believing systems could be built up to read something like this: ‘It is dangerous to be close and love too much. It is dangerous to trust. The very person I trust and love will betray me. He will do this because I have been too needy, too much. Maybe it’s better to separate and move away, but then I am terrified that I will disappear, or even die’.

Whenever Jim found his needs and longings drawing him close to me, his ‘early warning systems’ were activated and he would go into withdrawal. As soon as he distanced, he would feel isolated and abandoned, causing him to panic. This would then trigger his attaching behaviour. Jim’s defences against the anxieties inherent in the ‘too near–too far’ dialectic, as described above, would take two forms: he would either collapse into a state of mindless merger or one of arrogant, defiant isolation. These states could last for weeks, leaving me struggling to think while enveloped in this atelectic, mindless fog.

By the time Jim reached the fourth year of his analysis, he was slowly beginning to trust more and open up. His associations flowed more and he began to report dreams that often illustrated his attachment and struggles with me. The transference had become more openly eroticized and sensually explicit. He spoke of how soothing he found the smell in my room and how he would love to capture it in a bottle, to sniff in bed while trying to get to sleep.

One Friday, just prior to a long weekend, Jim walked towards the couch in my room but then slowed down and made a small detour towards me. He said, in an anxious but excited voice, that he had found a National Geographic magazine in the waiting room with a feature article on climate change and its effects on the Great Barrier Reef, which he would love to take home for bedtime reading. I was taken off guard, and became aware of the flood of anxiety and disquiet that had come over me. My response was clearly defensive and unthought: ‘By taking my magazine I believe you are attempting to manage your feelings relating to our parting ... denying our separateness and your dependence on me ... avoiding the emotional pain of your envious and possessive feelings towards me’.

Jim blurted out, in a cutting and hurt tone, ‘You’d think I was taking the last shirt off your back!’ He then became silent and withdrawn.

I began to experience feelings of dread, guilt and frustrated helplessness, regretting that I had not given the situation more thought. I felt like I was responsible for causing us to go backwards. Again, there was a sense of being engulfed by a dark, paralysing fog. My mind became dulled and I was finding it difficult to think coherently.

I would now like to explore the role that I, as therapist, have had in the development or destruction of the analytic ‘play’ space between Jim and me.

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4There is now neurobiological evidence that emotionally painful experiences sustained early in life become encoded, or ‘wired in’, to our subcortical structures, i.e. the amygdala and the hippocampus (van der Kolk, 2002). This applies not only to the most severe traumas, i.e. sexual and physical violations, etc., but also to ongoing painful disconnections and emotional impingements (Ogden, 1978).

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We might say that the space that we generate as analysts is a ‘dialectogenic’ space, by virtue of the fact that it is filled with inherent paradoxes and contradictions. These dilemmas, as I have discussed, provide multiple opportunities for the genesis of creative processes and change. When I offer Jim a quiet, thoughtful, empathic space, I am inevitably igniting his illusion that he can at last satisfy his deep unmet yearnings and desires for maternal merger, and illusion of oneness. No sooner was he embraced empathically by my warm ‘hand of illusion’ than he was met by my cruel ‘hand of reality’—a hand that separates. This takes the form of bills, time constraints and my analytic formality. Winnicott (1949) calls this ‘our hate in the countertransference’. Hoffman describes this as ‘the dark side of analysis’ (1998, p. 224). These contradictions inevitably awoke, for Jim, his early trauma of being ‘picked up and dropped’ at his mother’s whim. It is this dialectical tension between pain/frustration and soothing/gratification (inherent in our analytic setting and stance) that provides one of the creative edges which allows for the development of a creative space. Hoffman addresses this in the dialectic he calls ‘ritual vs. spontaneity’ (1998, p. 219). Here, Hoffman explores the tension that emerges out of the dialectic between the therapist’s role-determined behaviour (what he terms ‘ritual’) and his personal emotional presence (what he terms ‘spontaneity’). To quote Hoffman,

The analytic frame [ritual] provides the general boundaries for the relationship, a multifaceted scaffolding of

protection for both the patient and the analyst. It sets up the special ‘potential space’ in which

the play [spontaneity] of psychoanalysis can go on. (p. 220)

When I was a surgical intern, I was taught never to close a wound too early as it had the potential to create a pseudo-healing. The recommended practice was to keep the wound open by scraping away the scab as soon as it formed. This was to allow growth to occur from the base of the wound, allowing healthy tissue to eventually restore the wound. This process was called ‘de-breeding’. Like the surgeon, we have to balance what we have come to know and trust of our theory, practice and routine—theory that informs us of the positive outcome of being able to maintain and hold on to pain, frustration and discomfort. This is at odds with our more socially determined desires to nurture and heal by covering over, soothing and obliterating pain.

I will now try to show how this dialectic of ritual versus spontaneity threatened to close down, or collapse in me, in response to my own anxieties and tensions arising out of my interactions with Jim.

As mentioned earlier, Jim was in the powerful grip of his rigidly held believing systems relating to the ‘closeness–separateness’ dialectic. He had collapsed into a defiant mistrustful state of mind. I struggled to remain alert, thoughtful and hopeful in the face of the intense blanket of darkness and despair that hung over us. This struggle was threatening to derail our work. I felt unappreciated and under continual attack and criticism: ‘You’re stuck in the dark ages of psychoanalysis. You’re like a rusted-up robot! I’ve had enough traumas in my life; I don’t need to come here to get more pain and rejection!’

In the midst of this difficult phase, Jim recounted the following dream: ‘I felt like a little boy, a street urchin. I stared longingly into a window of a pastry shop. The bearded shop owner, who resembled you, appeared critical and stern, yet beckoned to me to come in. I was confused and anxious, and stood immobilized, staring. He came to the door with a plate full of scones. I was very suspicious; I was sure that the scones were stale leftovers. I didn’t want to chance being humiliated; I slunk away, feeling desperately hungry’.

I felt further criticised. To me, Jim’s dream seemed to echo his experience of my ‘stale’, mean interpretation of the National Geographic episode. I continued to lose my capacity to think clearly and responded with increasing defensiveness and uncertainty. I sought the comfort of my known analytic dogma (‘ritual’)—theories relating to envious attacks, impasses and negative therapeutic reactions (Klein, 1957; Rosenfeld, 1971, 1987). In this unreflective state, I continued to make the following types of interpretations, not unlike those I made in response to Jim’s request for my magazine: ‘Your regarding my scones/interpretations as stale leftovers I believe is your way of denigrating the help I offer you. I think it reveals that you resent your dependence on me ... you are unaware of the extent of your envy and how much this interferes with your willingness to take from me!’

The more reactionary I became, the more he would protest that I was cold, rigid and self-interested.

My responses and interpretations felt unhelpful and appeared to be retraumatising Jim. It did not occur to me at the time that I had become involved in an enactment that only served to confirm his worst anxieties—that he was too much, that he was unwanted and that he would be dropped whenever he trusted someone with his needs.

Winnicott’s words echoed in my mind:

Psychotherapy is done in the overlap of two play areas between the patient and therapist. If the therapist

cannot play, then he is not suitable for the work. If the patient cannot play, then something needs to be

done to enable the patient to become able to play. (1971a, p. 54)

With this in mind, it slowly became clearer to me that Jim’s increasing inability to play was directly related to my own loss of freedom and spontaneity. As I turned to my internal analyst/supervisor for some well-needed psychic resuscitation, my mental space became more ‘aerated’. I began to reflect on what had happened to our ‘play space’; what had been going on in me, in Jim and in us.

Jim’s experiential believing systems were enshrined in stone. They were immovable and filled his mind with intense, unquestioned ‘dogmas’ and ‘truths’, characteristic of a fundamentalist mind. It was becoming apparent to me that I, too, in parallel with Jim, had begun to resort to my own dogma/ritual as I became more anxious and defensive. My less reflective state of mind also rendered me more susceptible to Jim’s coercive attributions.

Enactment at the dialectic edge

When I was at the edge within the ‘too near–too far’ dialectic, my increasing anxieties and tension (not recognized at the time) began to override my holding/ containing capacity. Our analyses, I believe, do not completely free us of anxieties arising out of the core universal, existential anxieties relating to dialectics, such as the ‘closeness–separateness’ one. Close-proximity or excessive-distance triggers can still activate our universal fears inherent at the edge of this dialectic. Primitive, omnipotent, destructive anxieties in relation to self and others, as well as fears of annihilation, destruction, fragmentation and loss, are all represented (as stated earlier) by the triad that relates to core intimacy anxieties—to hurt, be hurt and the loss of self (Israelstam, 1989a, 1989b).

These primitive anxieties are more likely to become activated in us when we are confronted with projections such as Jim’s, which are so primitive, unintegrated and unmentalized. He appeared intent, and indeed was succeeding, in scripting me into the role of perpetrator in his experiential drama (Sandler, 1976).

It was becoming clearer that it was not only Jim’s capacity to influence me via his powerful and coercive projections, but my own resonating anxieties that made me responsive to his influence. I came to understand that when Jim began to open up to me with his longings—in the form of the magazine or the captured smell of the room—my anxieties relating to closeness were activated, causing me to seek distance through my ritualized interpretive stance. It is vital at this point that we are able, through our own emotional/reflective work, to manage these anxieties so as to be able to provide the free, oscillating reflection and holding/containment (i.e. ‘dialectic attunement’) that our patients require at this crucial point.

As my dialectical attunement began to wane, the conditions for the collapse/ atelectasis of our productive dialectical space increased. At the most intense moments of closeness or distance, I would experience myself collapsing either into withdrawal or overanxious placating behaviour—on one occasion, ending the session prematurely and, on another, going 10 minutes over time! I had failed to hold/contain my own and Jim’s anxiety at the crucial edge within the ‘closeness– separateness’ dialectic. The relational events that occurred between us mirrored his early experiential believings, arising out of the triad of fears, relating to distance and closeness. I had, indeed, ended up retraumatising him, confirming his negatively held experiential believing system. I had, I came to understand, become caught up in an enactment.

There is a growing consensus that enactments have potent transformational potential and are opportunities for newness and change. They often arise when there is a certain ‘stuckness’ and lack of creative vitality within the analytic space. It is my understanding that ‘the edge’ and ‘enactment’ have a very intimate relationship with one another, and I would like to focus on and explore this in relation to my work with Jim.

I believe that both Jim and I were unconsciously aware of the powerful anxieties that managed to hold us back in the ‘emotional fog’. It was as if we ‘knew’ that one way of dealing with our avoidance would be to risk moving closer to the edge within the fraught dialectic. The edge, because of its inherent flux, fluidity and ‘experience- near’ emotionality, provided a rich and evocative context in which the enactments could unfold. Jim was able to influence me to respond to this role of perpetrator through the projection of powerful and coercive attributions (Sandler, 1976). I was drawn into this unresolved drama by Jim, with the hope that a new relational context and configuration would occur that would help to bring about mastery and positive change. It was important for me to keep factoring in the notion that I, all be it unconsciously, would have inevitably influenced the genesis of this dynamic.

Jim had eventually, with his perseverance, managed to ‘nudge’ me right up to the edge of the ‘closeness–separateness’ dialectic. Unfortunately, due to my inability to hold/contain Jim at this evocative threshold, he tilted away from a creative newness, back into the darkness of mistrust.

When a collapse of a potentially creative, reflective space occurs during an enactment, it could be termed a ‘collapsed enactment’. If, on the other hand, the analyst is able to hold/contain the impending enactment at the edge, or is able to resuscitate the already collapsed space, we could term this a ‘reflective enactment’. It is these ‘reflective enactments’ that ultimately enable the edge to be transformed into a creative space.

One of Jim’s strengths has been his willingness, albeit after a time of withdrawal and hurt, to give me another chance to get it right. In this sense, he began to actively participate in the resuscitation of the atelectic emotional space that had occurred. In one of Jim’s more recent attempts, he said, ‘Although I’m very anxious and scared a lot of the time, I actually enjoy risk taking and challenges’. He had told me over the years of his interest in sky diving. On this occasion, he was telling me how much he enjoyed sky diving. He said that he would only do it at one centre that had an impeccable reputation for safety and diligence. He noted, ‘I always watch while my parachute is being packed, not only to learn how to do it myself, but to make sure that the person is concentrating! I’m not ready to jump on my own yet, and only do it in tandem, and that’s only with the instructor, who I’ve come to trust. If I don’t trust the instructor, I don’t jump’.

I don’t remember exactly what I said then but I probably would have referred defensively to the difficulty he had in trusting me! I was still not attuning to him correctly. He continued to persevere in helping me to understand by bringing forth the following dream, that had a similar theme to the parachute story and the pastry- shop dream: ‘I was in a stormy sea. The ship broke into pieces. I was clamouring alone in the water, terrified that I would drown. I saw a boat coming out of the shadows. You were standing there, beckoning to me to come into the boat. I couldn’t get to the boat and I was very unsure. I didn’t feel safe. I managed to grab on to a large piece of the boat. You kept telling me to let go and come to you. I was too scared. I felt that it would be safer to hold on to the driftwood’.

I was silent, as I usually was, waiting for his associations. On this occasion, however, he rather stubbornly said, ‘I want you to tell me what you think!’

In retrospect, I can see that these dreams, to which I responded so defensively, were his attempts to shed some light on the darkness—not unlike the defiant green banksia shoots that sprang out of the charred ruins on the forest floor. I was beginning to realise that I had been using my analytic knowledge to anchor myself and to insist that he do the associating so that I could be loyal to the ‘correct’ technique. This was clearly more in the service of my defences, rather than in the service of his development. Again, this could well be seen as my dropping him by putting my needs first, just as his mother did.

As my ‘ritual’ moved to the background and my ‘spontaneity’ to the foreground,
I felt freer to explore my more intuitive and personal responses. Instead of being
dominated by the dark, deathlike elements of Jim’s psyche and my own discomfort,
I was able to tilt towards more creative and positive thoughts relating to his quest
for mastery. I had a distinct feeling that I was being tested to see if I was capable of
putting him before my rigid psychoanalytic ritual.

Weiss (1997) posits that patients repeat traumas with their analysts, with the
unconscious wish to test out ‘pathological beliefs’ (akin to my believing systems)
within the context of the patient–therapist relationship. They do this in the hope that
these pathological beliefs will be disconfirmed, making it possible for them to begin
to take in new experiences and new perspectives of self and other. I was beginning
to understand that this edge was a place where he could best be challenging, testing
my capacity to be able to hold and contain him. In Winnicott’s (1969) terms, it might
be said that I was being tested as to whether I could survive his ‘usage’.

I said to Jim that I thought he had brought this dream to me as a way of trying to
test whether I would, yet again, use it to make interpretations about him not trusting
me. I said to him, ‘You want to know if you have been able to get through to me ... if
I would put you before my own need to hold to my analytic ways. I understand now
that, when you were telling me about your parachute instructor, you were letting me
know that you are prepared to, and do, take risks here with me. You took a huge risk
when you requested my magazine. You have also been trying to let me know that,
when you are most open and close to me, I always seem to manage to find a way of
dropping you. You want me to know that before you’d be ready to get into my boat
or have me pack your parachute, you would need to be surer that I can trust your
need and affection for me; that they will not overwhelm me’.

I also suggested to him that, by choosing a magazine on ‘climate change’, he
was letting me know that he was interested in trying to work with me to find ways
of improving our ecosystem, but needed my co-operation.

Jim seemed decidedly relieved when I said this, smiled and said, ‘I think you’re
getting it at last’. With further reflection, I realized that Jim and I were at a very
delicate edge within the ‘too near–too far’ dialectic. Both of our claustrophobic–
agoraphobic anxieties—all be they asymmetrical—were heightened and activated.
As his attachment to me intensified and deepened, so did his conscious fears of
closeness, based on unconscious wishes to merge. As his pull towards me escalated,
so did his push away from me increase. I began to understand that this edge, because
of its transformational potential, was a crucial and vital place. It is here that Jim could
best test the validity of his believings, which arose out of his traumatic experiences
in his early relationships with significant others.

As my dialectical attunement improved, I began to reflect on alternative ways of
seeing and experiencing Jim and my behaviours. It is true that throughout his analysisJim was often plagued by powerful, destructive, persecutory anxieties that were
related to intolerable envy and hatred of our separateness. What I believe I missed,
though, was an understanding of the delicate balance that existed between these
more destructive impulses (akin to death) and his newfound hope and willingness
to venture forwards tentatively into a close and trusting relationship with me (akin
to life). If Jim was to risk moving forward into ‘life’, I needed to recognise how
important it was for me to be able to provide the holding and containment that he
needed at that edge. In my anxiety, I had ‘foregrounded’ his more destructive elements
in my interpretations, losing touch with his more positive sides. I can see now that
his powerful projections were not simply designed to undermine my thinking. I
believe these projections were there to test my own capacity to contain/hold his
intense anxieties at the dialectical edge within the ‘too near–too far’ dialectic.
My propensities to experience his projections as evacuative or undermining were
probably more a function of my own anxiety within this very powerful dialectic.

Recently, Jim had a positive dream, which revealed that we were beginning to
turn a corner: ‘I was in my room downstairs. It was a hot humid day. I was feeling
terribly lonely. I had no air conditioner. The older man who lived upstairs had been
asking me to come upstairs to his place to play chess, but I always made excuses
[note that my waiting room is downstairs and I’m upstairs]. I couldn’t make up my
mind, I was anxious. I felt like a little lost soul. I didn’t want to humiliate myself by
being told to go away. I pushed myself to go. It was such a relief to be there. It felt
cool and fresh. We played chess—I’m not sure who won’.

The dream was obvious to both of us. We didn’t talk much that session. Near
the end, while wiping away some tears, he quietly said, ‘It’s as if I can feel my mind
breathing’.

Conclusion

When I look back at Jim’s initial assessment interviews, I am aware that it was
possible to identify evidence of Jim’s desire to seek a ‘climate change’, despite
his intense withdrawal and ‘encasement’. His curiosity and interest in discovering
new marine specimens and his willingness to take risks, e.g. sky diving, although
often hidden and subverted, was echoed in his work with me. I have attempted to
illustrate how Jim’s fears, inherent in the closeness–distance dialectic, stimulated
in him ‘believing systems’ related to the triad of anxieties—to hurt, be hurt and the
loss of self. I have tried to emphasize how these anxieties are at their peak at the
dialectical edge and that, as much as he yearned for meaningful contact, his early
traumas inhibited and, at times, crushed his normal developmental strivings, hopes
and desires.

I have tried to demonstrate how these ‘believing systems’ have the potential
either to be confirmed or disconfirmed. I have tried to stress that this depended on
how well I was able to hold/contain the powerful affects that became activated, not
only in Jim, but that also came alive in me as well. As my anxieties increased, I
would find myself tilting defensively towards ‘ritual’, within the ‘ritual–spontaneity’
dialectic. Jim had made it clear that he would only ‘sky dive’ if he could do this in tandem with an ‘instructor’ in whom he had confidence and trust. As I began to
work hard at processing my own anxieties and avoidant behaviours at the edge, I
was able to provide the holding and containment that Jim had not yet internalized
for himself. As my dialectical attunement improved, our atelectic space became
aerated, enabling Jim to mentally and emotionally ‘breathe’.

I want to stress that these ‘collapses’ and despairing ‘fogs’ often paradoxically
herald the presence of a potentially vital transformational edge, rather than indicating
the presence of an intractable impasse. This, I believe, can best be discovered through
examining and reflecting on the particular countertransference responses that come
alive at these edges. This was well illustrated in the experience I had on my deck as
I witnessed the raging bush fire unfolding. As the dialectical entities of life–death,
hope–despair and creativity–collapse collided and connected, I experienced the
welling up of powerful, confusing and contradictory emotions. I believe that it is
this very sense of confusion, paradox and contradiction that can alert us to the vital
presence of the edge.

Rosenfeld H (1971). A clinical approach to the psychoanalytic theory of the life and death instincts: An investigation into the aggressive aspects of narcissism. Int J Psychoanal 52:169–78. Rosenfeld H (1987). Impasse and interpretation. London: Tavistock. 250 p.